- Avoiding eye contact or preferring to be alone
- Struggling to understand others’ feelings or when others are upset
- Not speaking or having trouble developing language skills
- Repeating words or phrases without knowing how to use them
- Getting upset by minor changes in one’s routine or surroundings
- Focusing intently on a specific activity or interest
- Persistent repetition of thoughts, speech patterns, or behaviors
- Making the same movements or gestures repetitively, such as hand flapping or spinning (also known as stimming)
- Having unusual or intense reactions to sounds, smells, tastes, textures, lights, or colors (sensory processing issues)
Autism in Babies and Young Children
Autistic children might display very specific, sometimes intense, interests in subjects that others might not, says Jeremy Veenstra-VanderWeele, MD, the director of child and adolescent psychiatry at the Columbia University Department of Psychiatry in New York City. In a conversation, an autistic child might return intently to a single topic repeatedly. For example, one child Dr. Veenstra-VanderWeele worked with had a very strong interest in sharks and didn’t talk about any other topic.
- Delayed skills with language
- Doesn’t make eye contact with others
- Doesn’t respond to their name by 9 months old
- Doesn’t show facial expressions reflecting happiness or sadness by 9 months old
- Doesn’t wave goodbye or make other gestures by age 1
- Doesn’t share interests with others, such as showing you an object they like, by 15 months
- Doesn’t point to things that interest them by 18 months
- Can’t tell when others are upset or hurt by age 2
- Doesn’t notice or join other kids in play by age 3
- Doesn’t play pretend (such as with superheroes) by age 4
- Doesn’t sing, dance, or act by age 5
Not all autistic children exhibit all of these behaviors, and some signs show up at different ages or in different ways. For instance, a rare pattern of regression called childhood disintegrative disorder (CDD), also known as Heller’s syndrome, is sometimes seen and considered a part of the autism spectrum.
Autism in Older Children and Adults
- They have trouble understanding what others are thinking or feeling.
- They take things very literally and struggle to understand sarcasm, idioms, or figures of speech.
- They have difficulty reading nonverbal cues like body language, facial expressions, or tone of voice.
- They find it hard to express their own emotions or understand social rules intuitively.
- They avoid eye contact or find it uncomfortable.
- They are highly focused and have intense interests in specific subjects or hobbies.
- They repeat certain movements, sounds, or phrases.
- They are more or less sensitive than others to sensory experiences, such as bright lights, loud noises, and certain textures or smells.
Diagnosing autism in previously undiagnosed adults can be challenging because the condition is so variable and can affect people differently over time, especially as people develop ways to manage or mask (or camouflage) their difficulties, says Veenstra-VanderWeele.
How Autism Can Differ by Sex
Additionally, some studies suggest that when autistic girls and women experience difficulties, like social challenges or sensory processing issues, they are more likely to turn their distress inward. This might mean they’re more likely to develop anxiety, become depressed, or quietly withdraw.
